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Roboterassistierte Chirurgie in der Kopf-Hals-Region

Robot-assisted surgery in the head and neck region

  • Leitthema
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Die Onkologie Aims and scope

Zusammenfassung

Hintergrund

In der Kopf-Hals-Chirurgie haben sich die roboterassistierten Eingriffe noch nicht in der klinischen Routine etablieren können. Dies steht im Gegensatz zu der früher herrschenden Begeisterung für die transorale roboterassistierte Chirurgie (TORS) und den robotischen Erfolgen in anderen Fachbereichen, wie Allgemeinchirurgie, Urologie und Gynäkologie.

Methoden

In der vorliegenden Übersichtsarbeit werden einige der aktuell verfügbaren robotischen Systeme für die Kopf-Hals-Chirurgie beschrieben. Hierfür wurde eine selektive Literaturrecherche mit den Stichwörtern „head“, „neck“, „TORS“, „robotic surgery“, „oncology“ und „skull base“ in der Datenbank PubMed durchgeführt.

Ergebnisse

Die aktuell verfügbaren Systeme sind für den regelmäßigen Einsatz im Kopf-Hals-Bereich nicht ausreichend angepasst, was an den anatomisch begrenzten Platzverhältnissen und den teilweise schwer erreichbaren Operationsarealen liegt.

Schlussfolgerung

Für die notwendige Adaptation erscheint der Markt im Kopf-Hals-Bereich nicht ausreichend groß zu sein. Außerdem sind regionale Unterschiede zu berücksichtigen. Die Roboterchirurgie allgemein und auch TORS sind im angloamerikanischen Raum deutlich weiter verbreitet als im europäischen oder asiatischen Markt. Trotz allem zeigen einige Machbarkeitsstudien das Potenzial, aber auch die Konflikte bei der Anwendung von Robotik in der Kopf-Hals-Chirurgie auf.

Abstract

Background

In head and neck surgery, robot-assisted interventions have not yet become established in clinical routine. This is surprising given the earlier enthusiasm for transoral robot-assisted surgery (TORS) and robotic successes in other specialties such as general surgery, urology and gynaecology.

Methods

The review article describes some of the currently available robotic systems for head and neck surgery. For this purpose, a selective literature search was carried out on PubMed using the keywords “head”, “neck”, “TORS”, “robotic surgery”, “oncology” and “skull base”.

Results

The currently available systems are not adequately adapted for regular use in the head and neck area due to the anatomically limited space and the sometimes difficult to reach operating areas.

Conclusion

The market in the head and neck area does not appear to be large enough for the necessary adaptation. Regional differences must also be taken into account. Robotic surgery in general and TORS are much more widespread in the Anglo-American region than in the European or Asian markets. Nevertheless, some current feasibility studies show the potential, but also the risks in the use of robotics in head and neck surgery.

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Authors and Affiliations

  1. Klinik für Hals‑, Nasen‑, Ohrenheilkunde und Kopf-Hals-Chirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland

    P. J. Schuler, F. Böhm, M. N. Theodoraki, J. Greve & T. K. Hoffmann

  2. Surgical Oncology Ulm, i2SOUL Konsortium, Ulm, Deutschland

    P. J. Schuler, F. Böhm, M. N. Theodoraki, J. Greve & T. K. Hoffmann

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  1. P. J. Schuler
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  2. F. Böhm
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  3. M. N. Theodoraki
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  4. J. Greve
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  5. T. K. Hoffmann
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Corresponding author

Correspondence to P. J. Schuler.

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Interessenkonflikt

P. J. Schuler, F. Böhm, M. N. Theodoraki, J. Greve und T. K. Hoffmann geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Schuler, P.J., Böhm, F., Theodoraki, M.N. et al. Roboterassistierte Chirurgie in der Kopf-Hals-Region. Onkologie 29, 24–28 (2023). https://doi.org/10.1007/s00761-022-01251-3

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  • DOI: https://doi.org/10.1007/s00761-022-01251-3

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